Not All Who Wander Are Lost… Everything you ever wanted to know about my Dominican mission work

Such an exciting, exhausting, exhilarating week… it’s going to be impossible to summarize – but I’ll give it a try.

Right now, my Delta flight is about 45 minutes south of Atlanta.The pilot is stepping on the gas a little bit, because we have a passenger who is going to be put right on an ambulance as soon as we land. I was not involved in his care, but I think he may be having some blood sugar issues.Hopefully, everything will work out fine for him and his family.

Our last couple of days have involved quite a bit of decompressing.As usual on Friday, we spent a little bit of time in the Colonial Zone of Santo Domingo. The bus parked near the original home of Christopher Columbus’ brother, Diego.I had always wanted to see that area, so it worked out perfectly.Coincidentally, there was a nice little outdoor café where one of my new friends (Tammi) and I enjoyed a refreshing sangria.This group doesn’t have the strict “no drinking” rule that my ONU team has!Yay!

This is the home of Christopher Columbus’ brother, Diego. Pretty swanky, right?

Once we got checked into our hotel for Friday night, we all immediately hit either the beach or the pool to get cooled off.Don’t get excited… we were not at any kind of a 5 star resort.Solid Rock has a strict budget to follow, and they do the best they can to get us the best accommodations possible.The rooms were ok, if a tad bit damp, and most of us had some kind of problems with either plumbing, linens or air conditioning.But hey – when you’ve spent the week working in the mountainous villages of a third world country, you really can’t complain about first world problems, right?

The people in the room next door woke us up way early this morning… so my roommate and I went down to the beach to catch this stunning sunrise. Boca Chica area, just outside Santo Domingo, DR

I am thankful to have bonded with quite a few people in this group… people who were complete strangers to me just one week ago!The nursing students from Neumann University were awesome.They soaked up every bit of knowledge and experience that came their way.They even latched on to the Breast Self-Exam teaching project that I always do in the D.R., performing the small group instruction in 3 villages while I was working in the operating room.Several of them asked if I could please move to Pennsylvania and be one of their instructors!

Breast Self Exam teaching by Neumann University students and our own Bienvenida Suero, in the streets of a tiny village outside of El Cercado, DR

Speaking of Breast Self-Exam instruction, I am happy to note that this is the sixth trip during which I have continued this project in one way or another.Many, many Dominican Health Promoters have been taught to continue the teaching all through the year.I estimate that as many as 1,000 women in the Western Dominican Republic have been taught this life-saving skill.Solid Rock International has taken note, and is going to feature a story about this project in one of their upcoming newsletters.

Some of the more tech-savvy peeps in the group have created a photo-sharing file, and are going to create a photo book within the next week.During my Atlanta layover, I am going to try to upload my photos to their folders.I’m excited to be able to see the whole trip, and to share my photos with everyone, too.Plus… I get to have a copy of the book without doing all of the work to create it!Bonus!

It’s been an honor and a privilege to have served on my sixth Dominican mission trip.I hope to return in May 2018 to do more good work with more good people.Adios. Vaya con Dios.

It’s Friday morning at 5:45 a.m. In one hour, we’ll have breakfast… then it will be time to finish packing, strip the sheets and towels, take the traditional group picture in front of the cabana and then hop on the bus to head back to “civilization”. We’ll spend an hour or so exploring the Colonial Zone of Santo Domingo, then head to the hotel where we’ll spend the night before catching our respective planes back home tomorrow afternoon.

If anyone at Delta Airlines asks where all the blankets are going, let them know that we’re using them to cover patients during surgery. Thanks for the donation!

So, this hasn’t been a “typical” mission experience for me at all! But maybe my typical has now changed? I don’t know. I usually spend quite a bit of time in the barrios, bonding with the children, especially. This trip, I was in the barrio on Monday and in the operating room the rest of the week. No time to even visit the barrio behind the guesthouse to walk in the streets, hold hands and talk with the kiddos. I kinda missed that connection… but…

Man-Oh-Man did we do good work in the operating room. Yesterday was a 12 hour marathon. Gallbladder, hernia repair, huge abdominal lipoma removal and an exploratory laparoscopy with double hernia repair. It’s amazing that these procedures can be done here with the limited equipment available.

Our surgical technician for the week is Vonda. She is a tough little cookie with a heart of gold. She stood on her feet for 12 hours per day, 4 days in a row… rarely taking a break. Next week she’ll have double knee replacement… so you know those legs have been killing her this week! She threatened to slap the hand of anyone who reached onto her mayo stand for an instrument, so I decided to test her. As you can see in the pic, she wasn’t kidding!

Our last patient of the day was an unexpected difficult intubation. She bronchospasmed under anesthesia and it was all hands on deck to get her stabilized and ready for surgery. Great teamwork by an amazing group of professionals

More than ten years have passed since I worked 12 hour shifts… and this week has proven to me that my current 8-9 hour per day schedule is just fine, thank you. Right now, even after a good 6+ hours of sleep, by feet and legs are killing me and I’m in need of a full body massage and pedicure. Maybe I can find someone to help me with that at the hotel?

I’ll wrap this up by giving props to the amazing core group of professionals I have worked in the O.R. with this week. These folks have busted their butts to take care of more than a dozen Dominicans who otherwise would not have been able to find relief for their problems. Most of the Dominicans have been in pain and have waited months for this team to get here. They may have ridden on the back of a motorcycle or taken a bus from their remote village in order to have their hernia repaired or their painful gallbladder removed.

It’s Thursday morning, 5:27 a.m. The surgical technician in our group knocked on our door at about 4:45 to wake up Cathy, the group leader. One of our surgery patients from yesterday stayed overnight in the recovery room and needed some pain medication! I was already awake, as I had dozed off and on since 1:30 a.m. when my phone rang with a man calling to tell me that I had $45.27 coming my way from a Netscape class action lawsuit. All I needed to do was give him my address! Nope.

Yesterday was a good day in the operating room. We did 3 procedures. Just like at home, the nursing students love to come to the OR to see and do things they normally can’t in their clinical rotations. They’re like little sponges, and it’s a great opportunity for them to learn in a real-life environment.

Three of the nursing students enthralled with their surgical experience yesterday. Look at those faces!

There are 2 operating rooms here at Clinical Christiana, which is on the same compound as the guesthouse where we sleep and eat. We have been using OR #1, because it has a decent wall-mounted air conditioner… so it’s decently comfortable to work in there. Don’t let that fool you, though, because this whole property was under about 5 feet of water many years ago during a flood/hurricane. The floors and walls are cracked beyond repair and there’s no budget for things like electrical outlet covers and light fixture covers. This is the best surgery option in this whole part of the country and people come here for miles around to be seen, but inspectors in U.S. hospitals would close this place down right now.

The view from inside the operating room, looking out at the colorful laundry on the clothesline. I love how it looks like a kaleidoscope. In the right lower corner is a little bird that landed on the windowsill.

So the daytime temps and humidity levels have been in the 90’s here this week… without the usual afternoon rainshowers that we see when we are here in May. Thanks to some donated super-size oscillating fans in the bedrooms, sleeping has been decently comfortable. Also, the fans make a lot of noise, which drowns out the “crowing 24/7” roosters in the nearby barrio.

The water supply at the guesthouse has been improved, so it’s no longer necessary to take a military shower (get wet, water off, lather up, faucet on, rinse off). There is no hot water, but in this heat a cool shower feels pretty good.

The dynamic of this group is a lot different than the group I usually travel with. My usual group is mostly undergrad college students from Ohio Northern University, mixed together with a few nursing professors and alumnae or other “grown ups”. While they are certainly very mature and responsible college students, they’re still 20 somethings in all ways. This group is mostly grown ups. Working adults in their 30’s to 60’s (maybe 70’s?) mixed in with a group of 9 nursing students. Of those students, only about 4 are in their twenties. We have a very experienced surgical technician, an electrical specialist, a pharmacist, several ICU and recovery room nurses, a nurse educator, etc. Lots of knowledge here this week.

Out to dinner last night at a local restaurant. The group is really getting along well!

When I come back in May, it will be with the ONU group and we’ll be joined by Dr. Skip Johnstone’s GYN surgery group from North Carolina. That will be a nice combination of barrio work and operating room work.

Even at this time in the morning, the internet service is pretty sketchy… not sure when I will be able to get this posted. Hopefully, I will have more fun pics and stories to share later tonight or tomorrow morning before we leave (already?) San Juan and head back to Santo Domingo.

Not many new pictures today because I spent my first of 3 work days in the operating room… not always the best place to take lots of photos! Instead, I’ll try to put some of my miscellaneous thoughts and feelings into words. I can guarantee that there won’t be much “creativity” to this writing, or even many introductory or transition sentences… ready?

So, this is the first time I have done a mission trip with a group of people I have NEVER met. I did not know one single one of these people… in fact, I had only talked with the group leader on the phone once and by email or Facebook a couple times. Usually, I travel here with people from Ohio Northern University, and I am one of a group of Nursing alumni and faculty who helps organize and supervise the whole experience.

I wasn’t really worried… let’s face it, I’m not shy. So I was really surprised to find myself sitting on the bus (full of strangers, waiting to drive away from the airport in Santo Domingo) having many second thoughts. What have I gotten myself into here? Who ARE these people? They don’t know me. I feel really left out. This kinda sucks. OK, you’re here now… take a deep breath, it’ll be fine.

So, I did. I took a deep breath (or 50) and it WAS fine. I found out that our group of almost 30 people is really a couple of different groups, including a class of Nursing students and their professor from a Pennsylvania university. The first night, I roomed with Stacy who is a Nursing Administrator with her local Head Start program, and who has a passion for Breast Health teaching! By the time we all ate dinner and trekked a few blocks to the local frozen yogurt joint, we had become travel buddies.

Take a look at the map of the country. To the far right is the Punta Cana resort area that most people think is the only place in the Dominican Republic. In the middle/South of the country is the capitol city of Santo Domingo, where our flight landed. Follow the road West along the coast and then NorthWest to the area of San Juan de la Maguana. This is the region we work in. The area to the far East is the country of Haiti

I’m still basking in the wonderful feeling of seeing our sponsor student yesterday. I got such a nice message from her Mama, telling me that she thanks God for me loving her daughter and that Yasi loves me enough to call me Mommy.

From left, Josefina, Renji, me and Yasiri

Random thoughts:

When you’re showering in a bathroom with no hot water, you don’t have to worry about the mirror fogging up.

When your laundry gets done with everyone else’s laundry and then is put out on picnic tables for you to collect when you’re done working… you learn to count the number of pieces you put in so that you can be sure you get the same number of pieces back!

When there’s only one road in and out of the village where you’re working, you can spend a lot of time backtracking when the farmers decide to stage a protest by burning wood and parking trucks in the road.

It is not unusual to find that your road or bridge are at least partially washed out. If it looks like rain when you’re working in the barrios, you have to pack and leave quickly, or you could get stranded.

The surgeon I’m working with this week is Dr. Chris Olukoga, formerly of Pennsylvania but now from the Orlando area. He is a kind and patient man who also loves taking pictures. I am excited to get my hands on some of his photos, so I can share my trip from someone else’s perspective.

Relaxing in the cabana after a busy but successful day of surgery… with Dr. Chris and the cat that I’m NOT supposed to be feeding or bonding with.

Today was only the second time I have worked in surgery here at Clinica Christiana. Being a circulating nurse here is completely different than it is at home. Equipment here is OLD, refurbished, donated, makeshift or sometimes worse. The pace is slow. Most of the surgeons I work with at home would have gone APE-SHIT today. It took forever to get all of our equipment working just to take a gallbladder out. THEN… when we were finally underway… the electricity went out! REALLY? NO problem. The keyword here is FLEXIBILITY. We all worked together and got the four (yes, surgery peeps at home… ONLY 4 !) cases done for today. Tomorrow, we will do three and Thursday, four or five.

At home, when I work as a circulating nurse, a big part of my job is documentation. I have to do computer charting on every aspect of the procedure including positioning, medications, supply charges, specimens, implants, etc, etc. Here, the circulating nurse does absolutely NO charting. I do a verbal time-out from the patient’s consent and that is all. In most cases, specimens are not sent to pathology. Really… how necessary is it to have another doctor look at the organ you just removed and tell you that “yep, indeed… that is a gallbladder.” If a specimen does need to go to the lab, it is put in some kind of container (mayonnaise and jelly jars are popular) and given to the patient or their family. They are then responsible for getting the tissue and any necessary paperwork to a lab, along with proper payment for having the testing done.

Finally, I must thank the leader of this group, Cathy Case. She has done a remarkable job organizing the details for this trip. She brought a TON of surgical supplies and has every aspect of each work day under control. Not only that, but she was able to find a very generous woman at her church who kindly donated funds for me to join this group and provide the services they needed from an OR/Circulating nurse. I am grateful for the angels who got me here.

One of my favorite Dominican translators gave me the gift of these words when I saw him for the first time yesterday morning! How can your heart NOT melt when someone tells you this?

I’ve said it before, but it’s worth repeating… Americans could learn a LOT from the way the Dominicans interact with and appreciate each other.

So… it’s Tuesday morning (6:09) and the next 3 days will be in the operating room… but yesterday was a real thrill. I got to spend the day with the barrio team especially so that I could have a visit with Yasiri and her family.

Love this child

Our little sweetie was so shy… but she lit up like a little light bulb when she saw the baby doll that I brought for her – complete with an blanket, bottle and burp rag!

We continued on to the village of Gajo de Pedro, which is just past El Cercado. We were probably less than 1 hour from the border of Haiti. Immediately a man named Ernesto walked up to me and told me that he has troubles with his stomach and his shaking hands. When he was seen by the medical team, he got some antacids and a referral to a neurology specialist in the nearest clinic. We treated 99 additional patients of all ages and I was able to do a few Breast Self Exam teaching sessions.

Breast Self-Exam learning moment!

Breast self exam teaching in the street… guys and girls of all ages were interested – so we also covered testicular exams.

I’ll throw in a few of my favorite pics from the day, and then it will be time to gather in the dining room for a yummy Dominican breakfast before starting the first of 3 busy days in the operating room.

On the drive from the capital city of Santo Domingo to San Juan de la Maguana, I watched out the bus window as the landscape changed from crowded and dirty city streets to rice and plaintain fields and mountains in the distance.

I surprised myself by realizing that this place, the Western Dominican Republic, is one of the few places I have visited over and over again when I travel. This is my 6th trip here. I think that the Sarasota area of Florida is the only place I have visited more. No wonder both places feel so much like home.

The mountains to the East of San Juan de la Maguana

We put in a ton of hours, this afternoon, getting the medical and surgical supplies hauled into the pharmacy, clinic and operating rooms and then set up for the coming week. The team will be doing consultations tomorrow on about 30 patients, to make sure they are appropriate for surgery. We are expecting to do a lot of hernia repairs, gallbladders and some other general surgeries involving masses, cysts and breasts.

I am lucky to be able to travel with the barrio team to El Cercado tomorrow. On the way, we will stop at the elementary school so I can spend about 20 minutes visiting with Yasiri. You can be sure there will be lots of photos and news about the visit tomorrow!

For now, I will finish up this post… because the crew is going to come in and start clogging up the (very weak) wifi signal.

The little kitten I “did NOT become attached to” four months ago is still here!

I don’t remember being this superstitious when I was younger. I freely stepped right on top of sidewalk cracks. I never thought twice about broken mirrors. I didn’t have any “lucky charms”… well except for some deliciously yummy breakfast cereal with pink hearts and green clovers, and maybe that straw cowboy hat that went on a few high school volleyball bus trips… but, I digress…

But now… whoa! Is it only in the past decade or so that I’ve gotten more worried about full moons, barometric pressure and making sure I have three (not one or two, but exactly three) pens in my pockets when I start each work day? What about the pretty teal colored cross that a patient gave me? I’ll probably never take it down from its place hanging near my rear-view mirror! Is it a function of getting older, being a nurse, turning into my Grandma… or some crazy combination of the above?

Now that the days until I leave for the Dominican Republic can be counted on ONE hand, I have decided to bring all the things that have been worrying me right out into the open. Yep… they are going to be exposed to the bright, hot light of day in the hopes that by sharing, talking and writing about them… they won’t actually happen. So here goes.

Hurricanes– It’s been a horrible hurricane season. Texas, Florida, Puerto Rico and many, many Caribbean islands have been devastated by storms in the past few months. The Dominican Republic shares a Caribbean island with Haiti. I have been worried about all my friends there (thankfully everyone is fine), and have been hoping that another hurricane wasn’t following behind Maria at about the same time that I am due to be in the DR. Hurricane Lee has stayed out to sea and doesn’t seem to have a friend following close behind. Yay!

Health Scares– between my husband and I, we have three elderly parents. His Dad is very frail and barely eats enough to keep a bird alive. We worry that one little cold virus or flu bug could be extremely dangerous for him. My Mom found herself in the hospital a few weeks ago, with crappy blood sugar levels and even crappier kidney function. Thankfully, she’s in a rehab facility now and doing better. The healthiest one, my Dad, runs back and forth to visit Mom, does their laundry, makes his own meals and visits his best buddy (who just got a cancer diagnosis). Scary.

Random Other Bad Things – The hubby (who was extremely ill when I went on my last trip to the DR in May – see earlier blog posts) has had a massive tooth ache for more than two weeks. He’s been in excruciating pain, waiting to get a root canal done. Today’s the day. Thankfully, I think he will be on the mend by the weekend and my worries about local or generalized infection will be resolved.

The air conditioner already pooped out earlier this week (during a freak late-September heat wave in Ohio) and has been repaired. The cats, kids and grandkids seem to be healthy enough right now… so I’m going to try to stop finding things to worry about (car accident, tree falling on house, etc) and start focusing on the positive!

OK, so… let’s get some GOOD KARMA going… This will be my sixth mission trip to the Dominican Republic. Usually I go in May with a group from Ohio Northern University. This trip, I am joining a group from Pennsylvania that needed a surgical nurse. They asked me if I could come along, and they raised money to pay my expenses. I have never met a single person in the group, but I hope by this time next week to have more than 25 new friends!

As usual, my peeps have come through with donations for me to take on the trip. My friend Carol and her Oncology Nurses group generously donated cash to cover any expenses I might have (glucometer batteries, parking, meds, extra luggage fees, etc) I am happy to be packing lots of baby formula from my friends Lindsey, Jennifer and Melissa, sterile gloves, instruments and surgical towels from the hospital, vitamins and medical supplies from Amy at Rite Aid and a few highly-coveted glucometers, test strips, and lancets from my brother and Dad.

Happily, our sponsor child is doing very well right now. She spent over a month of her Summer hospitalized with a Sickle Cell Crisis. (Google it… these can be fatal). I was incredibly worried, but our little gal is looking good. I am lucky to be in contact with her and her family on Facebook. I get regular photos as well as frequent voice messages that go something like this, “Yo, Mami. Como esta?” “Y su esposo?” “Te quiero mucho… muah, muah”. Translations: Hi, Mommy. How are you? And your husband? I love you very much. kiss kiss. (insert sound of heart melting here).

Yasi (8 yrs old) wearing a dress we sent in her last care package

My work schedule for the upcoming week has been thoughtfully and carefully arranged so that I can spend some time with Yasiri on Monday morning. I can’t wait to give her a great big hug and see her smiling face!

happiness is…

There… I did it. All the bad things have been brought out of the dark. All the good things have been shared and celebrated. I am getting on a plane EARLY Saturday morning. I appreciate your help and good wishes for my journey.